Mark S. Gold is the Dizney Eminent Scholar, University of Florida Distinguished Alumni Professor, and chairman of psychiatry at the University of Florida, College of Medicine, McKnight Brain Institute.
Paula J. Edge is the editorial assistant to Dr. Mark Gold. She has been with the University of Florida, Department of Psychiatry, for 37 years and has coauthored several publications.
Food and alcohol cravings have many similarities: strong cravings experienced as overwhelming urges and loss of control are present in relapses of both. During the holidays, people are immersed in and surrounded by cues for alcohol, sweets, salty, and fatty treats. Grateful clients or patients bring cookies, donuts, candy, cakes, etc. to the office. How many times can one pass this cornucopia of delight without giving in to temptation? Once given in, some will not be able to stop with a small taste. Then there are the holiday parties: work/office parties, friends’ parties, and special potlucks at many churches.
Let us not forget to add the rising anxiety and stress of shopping, preparing for family visits, and the unrealistic expectations we burden ourselves with of the “perfect” holiday. It is enough to make anyone want a drink, a cigarette, some pretzels, and a chocolate bar! Did you know you can buy a giant bar of chocolate, labeled as “Emergency Chocolate”? No joke. It even has a bright red wrapper with a line drawing of an ambulance rushing somewhere.
How one should deal with cravings during the holidays has two main proponents. One says to enjoy what you want, but take small “tasting” portions and no seconds. That might work for some, but one of the hallmarks of an addict is “lack of control.” For these persons, the potato chip ad slogan of “You can’t eat just one!” is a very real fear. The second way to deal with holiday cravings is abstinence, which is the only route for those persons who can’t eat just a taste. They may fall prey to using a drink or a smoke to try and fend off cravings, again and again.
Alcoholics are urged to attend meetings, every day if necessary, and to stay away from parties where alcohol is freely available. Food addicts don’t have the same options—food is everywhere, and during the holidays, parties will invariably have the sweet, salty, and fatty treats so dangerous to the addict. Remember the hallmarks of food addiction are loss of control, eating more than intended, and being unable to say “no” and mean it.
Currently, the best advice for a food-a-holic is to avoid alcohol and liquid calories of any kind; drink water or tea instead. Watch your portion size and eat less than you planned. Don’t bring any food into the house that you don’t plan to eat; eat less fat and sugar; eat more protein instead. Keep fresh fruit and veggies on hand for snacking.
There is hope for the future. Much research by the likes of Hoebel, Gearhardt, Brownell, Robbins, Newman, and Volkow has suggested that treatments for overeating can be developed on the basis of addiction models.
In a recent letter to the editor of Biological Psychiatry, Nicole M. Avena and I wrote that animal models can lead the way by providing evidence that the same drugs used successfully in treating addictions can also be successful in treating overeating. Dietary fat intake can be decreased by the use of baclofen and naltrexone can suppress desire for some foods. In an animal study reported at the American College of Neuropsychopharmacology annual meeting, a naltrexone-baclofen combination suppressed binge eating of a sugar-fat emulsion.
There is enough evidence that certainly some human trials should be designed, even as research continues. For how many more holidays must the food-a-holic remain an outcast?